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�Y "'of Co0orrio---Envil&rrwoA Pro# cffoe Ape.rcy <br /> „pP,o—d OMS No.2050-0079(gyp:..9.36194) See Instructions on bock• $' -39e 6. <br /> Deport—rt of Tout Suboances Contr< <br /> Ph*or type. Form d-s pned for use on eiw(12-pi ,triter. Socronwnto,Califor:o <br /> I .. ... r Generator's US EPA ID No. - Manifest Docurte�n�No. 2. Page 1 Information in the shaded areas <br /> UNIFORM HAZARDOUS is not required by Fedora)law. <br /> WASTE MANIFEST C A -C 0 0 0 9 5 6 4 0 8 8 I 1 10 5 0 of 1 <br /> 3. Generator's Nome and Moiling Address <br /> ACME SAKI AND INDUSTRIAL SUPPLY <br /> WrP <br /> 1204 E. Main St. , Stockton, CA 95205 f <br /> A. Generator's Phone (209) 948-673500 <br /> 1 <br /> S. Transporter 1 Company Nome 6. US EPA ID Number <br /> C? <br /> NOR CAL OIL CAD 1918 12 14 11 17 12 1515 <br /> J <br /> 7. Transporter 2 Company Nome 8. US EPA ID Number <br /> Q <br /> V <br /> Q . Designated Facility Name and Site Address <br /> O Z 9g tY 10. US EPA ID Number <br /> In p REFINERIES SERVICE <br /> O 13331 North Hwy 33 7 <br /> coV <br /> WI1. US DOT Description(including Proper Shipping Nome,Hazard Class,and ID Number) 12. Containers 13. Total 14. Unit <br /> 00 E= No. T Ouantity Wt/Vol <br /> Fb. <br /> ARDOUS WASTE LIQUID N.O.S. <br /> N -E N -9189 0 0 4 TIT 6 G <br /> 00 w E <br /> v <br /> vc,4 R <br /> C5 A <br /> 00 T C. <br /> O <br /> z R <br /> LU <br /> Z d. <br /> Z <br /> w <br /> V <br /> LU <br /> N <br /> Z <br /> 0 <br /> rl <br /> N <br /> w <br /> tl' <br /> J <br /> Q <br /> Z <br /> 0 15. Special Handling Instructions and Additional Information <br /> Q <br /> Z APPROPRIATE PROTECTIVE CLOTHING SEE E.R.G. 31 <br /> U.1 <br /> "EMERGENCY CONTACT: 800-332-8710" <br /> J 16. GENERATOR'S CERTIFICATION: I hereby declare that the content of the consignment ore fully and accurately described above by proper shipping name and ore classified, <br /> Q packed,marked,and labeled,and ore in all respects in Proper condition for transport by highway according to applicable federal,state and iMerratiorwl kzws. <br /> V <br /> If I am a large qua" generator,I certify that 1 hove o program in place to reduce the volume and toxicity of waste genet d to the degree I have determined to be <br /> J economically practicable and that I have selected the practicable method of treatment,storage,to human heatih and the environment; OR, if I am o small quantity generator, I have or di oo�dl(off tly available me which minimizes the present and future <br /> En 9 e my waste generation and select she best <br /> at: waste mono emerM method that is avvilvble to me and that I can afford. <br /> 0 Printed/Typed Nome - Signature <br /> >_ Month Day Year V d Th r e for Acme Saw & Ind. upply2 8 9 3 <br /> Z T 17. Transporter 1 Acknowledgement of R"pt of Materials <br /> LU x <br /> 0 A Printed/Typed Name Signature <br /> CXNmonth <br /> LU s Joe Puett 0 9 218 9�3 <br /> W0 18. Transporter 2 Acknowledgement of Receipt of Material <br /> U_ T Printed/Typed Nome Si <br /> 0 x g Moreh Day Year <br /> N19. Discrepancy Indication Spoce <br /> 1J F <br /> _ A <br /> Z C <br /> 1 20. Foch Owner or rator Certification of r t of hazardous materials covered b this manifest exc os rested in Item 19. <br /> TP / y me <br /> Y' Signature Month Day Year <br /> DO NOt WRITE THIS NE. <br /> »�7A(7/92) White: TSDF SENDS THIS COPY TO DTSC WITHIN 30 DAYS. <br /> To: P.O. Box 3000, Sacramento, CA 95812 <br />